Acute pancreatitis is a sudden inflammation that occurs over a short period of time. In the majority of cases, acute pancreatitis is caused by gallstones or heavy alcohol use. Other causes include medications, infections, trauma, metabolic disorders, and surgery. In about 10% to 15% of people with acute pancreatitis, the cause is unknown. Endoscopic retrograde cholangiopancreatography (ERCP) has been used for the diagnosis and treatment of pancreatic diseases. This procedure is performed on an outpatient basis under sedation (rarely under general anesthesia). ERCP is associated with a 5%-10% risk of pancreatitis. The risk is increased in those cases where cannulation of the ducts is difficult, the pancreas is normal, or when a sphincterotomy is performed in the setting of sphincter of Oddi dysfunction. A prior history of ERCP-induced pancreatitis is also a risk factor. Other less common risks include bleeding, infection and perforation. Particularly in the setting of pancreatic disease, it is a specialized procedure that should be performed only by experienced endoscopists.
There is a high morbidity and mortality rate for pancreatitis. See Baron, et al, 1999 and Steer et al., 1995. Pharmacologic means of decreasing pancreatic secretion have been attempted with limited success because of the dose-limiting side effects encountered with the drugs, their lack of specificity or their lack of availability. The vagus nerves are strongly implicated in the pathophysiology of pancreatitis. Yoshinaga, et al., 2000. Atropine is a drug that blocks parasympathetic (vagal) nerve endings. It is known to be desirable to use atropine in acute pancreatitis patients to down-regulate pancreatic activity. Unfortunately, for most such patients, this drug cannot be used due to its many side effects.
A need continues to exist for additional feasible and suitable means to treat pancreatitis. Likewise, a need continues to exist for additional feasible and suitable means to treat other gastrointestinal tract disorders.